Doctor Says Female Patient Lost Her Toenails After a Fish Pedicure

According to a case report published by the woman’s doctor in JAMA Dermatology, the woman’s toenails stopped growing and soon fell off after she received the pedicure.

“A fish pedicure is a treatment in which the feet are immersed in a tub of water at a temperature of 25°C to 30°C that is filled with small fish called Garra rufa or ‘doctor fish,'” according to Shari Lipner, the doctor.

“Garra rufa are a nonmigratory, freshwater species that belong to the carp family (Cyprinidae) and are native to waters from the Persian Gulf to the eastern Mediterranean. In their natural habitat, suction assists them in sticking to rocks while they ingest plankton. Being omnivores, when there are insufficient plant sources, they will eat human skin.”

Lipner said it took about six months for the toenails to start falling off.

“I think that this is probably more common than we think,” Lipner told NBC.

“We don’t see the [nail] shedding until months after the event, so I think it’s hard for patients and physicians—especially if they’re not even aware that fish pedicures can do this—to make that connection.”

The patient didn’t have any other medical history that Lipner could link to the loss. She said she’s fairly sure that it was the fish pedicure.

“While the mechanism of action is not entirely clear, it is likely due to the fish traumatizing the nail matrix,” Lipner told Gizmodo.

Lipner couldn’t reveal where the woman got her pedicure but noted that many women receive the treatement outside of the United States, including in China. The treatment is popular in America but has been banned in at least 10 states, including New York, because of health concerns.

Concerns include the worry that the fish can transmit infections when used on more than one person.

“I do not recommend fish pedicures for any medical or aesthetic purpose,” Lipner said. “In addition to onychomadesis [toenail loss], there are also serious infections associated with fish pedicures.”

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